Credentialing Specialist (ABA / Insurance Credentialing VA)

Global Pacific Support is seeking an experienced Credentialing Specialist to support Ready Set And Go ABA, a provider of compassionate and evidence-based Applied Behavior Analysis (ABA) Therapy services for children with autism.

The ideal candidate has experience credentialing behavior analysts and therapists with US insurance payers.

Responsibilities

• Process provider credentialing applications
• Manage CAQH provider profiles and updates
• Credential providers with insurance networks such as:
• Aetna
• Cigna
• UnitedHealthcare
• Blue Cross Blue Shield
• Tricare
• Maintain credentialing documents and licenses
• Track credentialing status and payer approvals
• Follow up with insurance companies regarding applications
• Ensure compliance with payer and regulatory requirements

Requirements

• ✔ At least 2 years experience in US medical credentialing
• ✔ Experience credentialing Board Certified Behavior Analysts (BCBA), therapists, or healthcare providers
• ✔ Experience with CAQH, NPI registration, and payer enrollment
• ✔ Strong knowledge of US insurance credentialing process
• ✔ Excellent documentation and communication skills
• ✔ Ability to work independently

Preferred

• ABA therapy credentialing experience
• Familiarity with CPT codes and ABA billing
• Experience working with US healthcare practices